Novosti
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This journal is indexed in Scopus |
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Year 2023 Vol. 31 No 6
CASE REPORTS
E.A. TONEEV 1, 2, A.A. FIRSTOV 2, E.A. KESHYAN 4, O.V. PIKIN 3, L.A. DANILOVA 1, A.A. MARTYNOV 1, A.V. GINOV 1
IMMEDIATE SURGICAL RESULTS OF GASTRECTOMIES FOR GASTRIC CANCER. EXPERIENCE OF THE REGIONAL ONCOLOGY CENTER
Municipal Healthcare Institution "Regional Clinical Oncology
Dispensary of Ulyanovsk City" 1,
Ulyanovsk State University 2,
P.A. Herzen Moscow Scientific Research Oncology Institute – Branch of the Federal State Budgetary Institution "National Medical Research Center of Radiology" of the Ministry of Health of Russia 3, Ulyanovsk,
Russian Federation
State Budgetary Institution "City Clinical Hospital №15 named after O.M. Filatova Moscow health department" 4, Moscow,
Russian Federation
Objective. Comparative assessment of two options for the formation of esophago-enteric anastomosis (EEA) after gastrectomy – hand-sewn and stapled. Assessment of the impact of an increased risk of nutritional deficiency in the development of postoperative complications.
Material and Methods. 173 patients with stages I-III of gastric cancer were divided into 2 groups depending on the type of anastomosis formed – hand-sewn (n=106) or stapled (n=67). All the studied patients were analyzed for the presence of an increased risk of nutritional insufficiency on the MUST scale (Malnutrition Universal Screening Tool).
Results. In the group analysis, the statistically significant parameters based on the main clinical and anamnestic data was not identified. In the group of patients with hand-sewn anastomosis tumors localized in the cardiac part of the stomach were more common, whereas with stapled anastomosis the tumor was more often localized in the body of the stomach (p< 0.001). Perioperative parameters such as blood loss were higher in the stapled anastomosis group (р=0,037). The formation time for the hand-sewn anastomosis was longer than for stapled anastomosis (p <0.001). Other parameters did not differ between groups, including the volume of lymph node dissection, the number of removed lymph nodes. Serious complications (Calvien-Dindo IIIA-V scale) were more common in the stapled anastomosis group (p=0.036). Among 55 patients with postoperative surgical complications, 27 (49%) patients with an increased risk of nutritional insufficiency were identified: 17 (63%) of them with a high nutritional risk and 10 (37%) – with an average.
Conclusion. The frequency of EEA failure after stapled anastomosis was 1.15% in our retrospective study, and 0% after hand-sewn anastomosis, but a statistically significant difference was not achieved (p = 0.073). There were no significant differences in the time of surgical intervention, despite the presence of a statistically significant difference in the time of anastomosis formation. The increased risk of nutritional insufficiency plays an important role during the postoperative period. In 49% of cases, postoperative surgical complications occur in patients with an increased risk of nutritional insufficiency.
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432017, Russian Federation,
Ulyanovsk, 12 September St, Building 90,
State Healthcare Institution «Regional Clinical Oncology Dispensary»,
tel.: +79084731198,
e-mail: e.toneev@inbox.ru,
Toneev Evgeny A.
Toneev Evgeny A., PhD, Thoracic Surgeon of the Surgical Department of Thoracic Oncology at the State Clinical Oncology Dispensary of Ulyanovsk, Associate Professor of the Faculty Surgery Department, T.Z. Biktimirov Medical Faculty, Institute of Medicine, Ecology, and Physical Education, Ulyanovsk State University, Ulyanovsk, Russian Federation.
http://orcid.org/0000-0001-8590-2350
Firstov Artemii A., Resident of the Department of Hospital Surgery, Anesthesiology, Intensive Care, Urology, Traumatology, and Orthopedics, Faculty of Dentistry, Pharmacy, and Postgraduate Medical Education, Institute of Medicine, Ecology, and Physical Education, Ulyanovsk State University, Ulyanovsk, Russian Federation.
http://orcid.org/0000-0002-2551-9795
Keshyan Eric A., PhD, physician of the surgical department of the State Budgetary Institution «City Clinical Hospital No. 15 named after. O.M. Filatov DZM”, Assistant of the Department of Hospital Surgery, Russian National Research Medical University named after. N.I. Pirogov, Moscow, Russian Federation.
http://orcid.org/0000-0001-5557-1925
Pikin Oleg V., MD, Professor, Head of the Thoracic Surgery Department, P.A. Herzen Moscow Oncology Institute – Branch of the Federal State Budgetary Institution «National Medical Research Center of Radiology» of the Ministry of Health of Russia, Moscow, The Russian Federation.
http://orcid.org/0000-0001-6871-6804
Danilova Lyudmila A. PhD, First Deputy Chief Physician of the State Healthcare Institution OKOD Ulyanovsk, Associate Professor of the Department of Oncology and Radiation Diagnostics, Faculty of Medicine named after T.Z. Biktimirova, Institute of Medicine, Ecology and Physical Culture, Ulyanovsk State University, Ulyanovsk, Russian Federation
http://orcid.org/0000-0002-0060-4061
Martynov Alexander A., Thoracic Surgeon, Head of the Surgical Thoracic Department, State Clinical Oncology Dispensary of Ulyanovsk, Ulyanovsk, Russian Federation.
http://orcid.org/0000-0003-4662-9886
Zhinov Anatoly V., PhD, Surgeon, Head of the 1st Surgical Department of the State Healthcare Institution OKOD, Ulyanovsk, Russian Federation
http://orcid.org/0009-0009-1738-100X
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